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Biomedical subjects

D K Mehta

Publications and source records attributed to D K Mehta.

At least 19 recordsLinked to original sources
PubMed2005

Ocular angiostrongyliasis in a child--first case report from India.

A rare case report of Angiostrongylus cantonensis (rat lung worm) from the eye is presented here. This worm generally causes eosinophilic meningo-encephalitis and accidentally infects humans by ingestion of uncooked snails, slugs, frogs etc. The child was presented to us with diminished vision in left eye. Slit lamp examination showed an actively motile worm in the anterior chamber. Surgical extraction of the worm was performed and it was identified as A. cantonensis. This is the first case of ocular A. cantonensis infection from India with no signs or symptoms of meningitis. After surgery, the visual acuity of the patient returned to normal.

Angiostrongylus cantonensis↗
PubMed2005

Phacoemulsification after penetrating keratoplasty with autologous limbal transplant and amniotic membrane transplant in chemical burns.

We report a patient who had earlier penetrating keratoplasty with amniotic membrane transplant and autologous limbal cell transplant for chemical injury who underwent cataract surgery by phacoaspiration. A posterior limbal incision with corneal valve was made superotemporally with extreme caution to avoid damage to the limbal graft. Aspiration flow rates and vacuum were kept low to avoid any turbulence during surgery. A 6.0 mm optic diameter acrylic foldable intraocular lens was inserted in the bag. The patient achieved a best-corrected visual acuity of 6/12 at 10 months' follow-up with a clear corneal graft. We conclude that caution during wound construction and phacoaspiration can help preserve corneal and limbal graft integrity in patients undergoing cataract surgery after corneal graft and limbal transplantation.

Adult↗
PubMed2005

Spectrum and antibiotic susceptibility pattern of bacterial isolates from conjunctival swabs.

Conjunctivitis is the most common disease of conjunctiva which occurs by exogenous or endogenous source. Bacterial conjunctivitis is the most common type of this infection for which emperical treatment is started without knowing the etiological agents because prior cultures are generally not taken. We conducted this survey to study the etiological agents of conjunctivitis in a total of 6763 swabs obtained over a period of four years (2001 to 2004). The prevalence of bacterial conjunctivitis was found to be 20.4% with a predominance of Staphylococcus aureus (87.2%) followed by Streptococcus pneumoniae (4.7%) and gram negative rods (E.coli + Klebsiella spp. + Pseudomonas spp.) in 8.1% swabs. For S. aureus, amikacin showed maximum sensitivity (73.2%) while for S. pneumoniae, cefotaxime (90.6%) and cefazolin (89%) were found to be highly sensitive drugs. For gram negative rods, ceftazidime (74.1%) and cefotaxime (67%) were found to be preferred options. Thus it is concluded that bacterial conjunctivitis in our hospital is predominated by S. aureus. The bacterial isolates obtained from conjunctiva have not yet attained a high level of antibiotic resistance and hence averts the need to unnecessarily start new/latest generations of antibiotic eyedrops or antibiotic combination which may lead to acquisition of resistance by these bacteria.

Bacteria↗
PubMed2004

Tubercular preseptal cellulitis in children: a presenting feature of underlying systemic tuberculosis.

OBJECTIVE: To present the clinical findings in 7 patients with preseptal cellulitis caused by tuberculosis. DESIGN: Retrospective noncomparative interventional case series. PARTICIPANTS: Seven patients. METHODS: Review of clinical findings, course, diagnostic tools, and management of 7 cases with tubercular preseptal cellulitis. MAIN OUTCOME MEASURES: Healing of local and systemic lesions, cosmetic correction. RESULTS: The presenting features of tuberculosis included lid abscess formation in 5 cases, with spontaneous fistulization in 2 patients. Two cases were initially seen with a cicatricial ectropion of the upper lid. A history of a lid swelling with spontaneous fistulization was present in both cases. Nonresponsiveness of the lesions to systemic antibiotics led to a detailed evaluation of the patients, and evidence of an underlying active or healed systemic focus was present in all the cases. Acid-fast bacilli from pus from the discharging sinuses were identified in only 1 case, and in another patient, a biopsy specimen of the submandibular lymph node showed caseation necrosis. In the other cases, the diagnosis was presumptive from a strongly reactive Mantoux test, raised erythrocyte sedimentation rate, and the presence of a systemic focus. All the patients showed a dramatic response with antitubercular treatment, with complete healing of lesions. Two patients had a residual cicatricial ectropion, which was corrected surgically in both cases. CONCLUSIONS: Preseptal or lid involvement can be the presenting feature of tuberculosis and a marker for underlying systemic focus in children. Spontaneous fistulization of the abscess, minimal inflammatory signs, nonresponsiveness to antibiotic therapy, tethering to the underlying structures and skin, and the presence of a cicatricial ectropion should alert the clinician to look for an alternate diagnosis. The lid presentation might be a marker of an underlying systemic focus; therefore, awareness of the many faces of tuberculosis is important for ophthalmologists.

Antitubercular Agents↗
PubMed2002

Efficacy of lamellar division for correcting cicatricial lid entropion and its associated features unrectified by the tarsal fracture technique.

OBJECTIVE: To determine the efficacy of lamellar division for correcting cicatricial lid entropion and its associated features unrectified by the tarsal fracture technique. METHODS: Fifty patients (92 lids) diagnosed as having cicatricial lid entropion were operated by the tarsal fracture technique. There was defective lid closure in 34/92 lids, irregular lid margin in 48/92 lids, distichiatic or metaplastic cilia in 28/92 lids and a history of previous entropion surgery in 34/92 lids. All patients were followed up for one year and the surgical failures at the end of this period were subjected to lamellar division. These subjects were further followed up for one more year. RESULTS: An overall success rate of 28.26% (26/92 lids) was obtained with the tarsal fracture technique. A correction was achieved in all the 20 lids having cicatricial entropion without any associated features. However, this technique succeeded in only six of the remaining 72 lids (8.33%) with a history of previous surgery or the associated features stated above. Furthermore, it was not effective in correcting associated anomalies such as defective lid closure, irregular lid margin and distichiatic or metaplastic cilia. Reoperation using lamellar division gave good correction in 97% of the lids (64/66). CONCLUSIONS: Lamellar division is a better procedure for treating cicatricial lid entropion, especially in patients with associated complications or with a previous history of entropion surgery.

Adolescent↗
PubMed2001

Methanol-induced optic neuropathy: treatment with intravenous high dose steroids.

The aim of this study was to find the potential benefit of intravenous high dose steroids in the treatment of patients with methanol optic neuropathy. Four patients complaining of diminution of vision after taking methylated spirit presented to us within a variable period of its consumption. The systemic features of methanol poisoning were absent in these patients. Raised blood levels of methanol confirmed the diagnosis of methanol optic neuropathy. All these patients received high doses of intravenous steroids for three days, followed by oral steroids, 1 mg/kg body weight, for 11 days. The administration of high doses of intravenous steroids led to an improvement of visual status in all four patients. Intravenous high dose steroids benefit the visual status of patients with methanol-induced optic neuropathy, provided the interval between the consumption of methanol and starting treatment is short. Further studies should be undertaken to document the role of intravenous steroids in this context.

Adult↗
PubMed2000

Tubercular endophthalmitis simulating retinoblastoma.

PURPOSE: To report a case of tubercular endophthalmitis simulating retinoblastoma. METHODS: Case report. An 8-year-old female presented with a history of complete loss of vision and a white pupillary reflex in the left eye of 3 month's duration. RESULTS: Retinoblastoma could not be excluded on the basis of clinical examination and relevant investigational studies. In the left eye, a computed tomography (CT) scan demonstrated a large vitreous mass with foci of calcification. Enucleation in the left eye was performed, and histopathological examination revealed a chronic granulomatous endophthalmitis and acid-fast bacilli consistent with tubercular pathology. CONCLUSION: This case illustrates that tubercular endophthalmitis with leukocoria and a vitreous mass containing focal calcification may simulate retinoblastoma.

Blindness↗
PubMed2000

Disposable contact lenses in penetrating keratoplasty.

PURPOSE: To evaluate the therapeutic efficacy of disposable contact lenses in management of complications after keratoplasty. METHODS: Twenty-eight patients with various post keratoplasty complications were fit with disposable contact lenses (45% Vifilcon A and 55% water content). Indications for lens use included persistent epithelial defects, wound leak, graft edema, dry eye and protection of normal corneal epithelium. RESULTS: Success was obtained with the therapeutic use of disposable lenses in 20 of the 28 cases. The best results were seen in maintenance and restoration of healthy ocular surface and small wound leaks. Stromal graft edema with no epithelial involvement was the major area of therapeutic failure. CONCLUSIONS: Disposable contact lenses are an attractive low cost option in the management of complications after keratoplasty. They are particularly useful in maintaining a healthy ocular surface, providing symptomatic relief and avoiding resurgery in patients with small wound leaks.

Adult↗
PubMed1998

Seroepidemiology of ocular toxoplasmosis-profile of an urban population.

200 uveitis cases and 100 controls were serologically analysed for Toxoplasma antibodies (Ab) using indirect fluorescent antibody test (IFAT-IgG, Igm) and enzyme linked immunosorbent assay (ELISA IgG, IgM). Ophthalmologically cases were segregated into 4 groups anterior uveitis, posterior uveitis, pan uveitis and varied presentation uveitis. Toxoplasma seropositivity of 32% in cases and 4% in controls was established. IHA, IFAT, ELISA detected 20%, 18% and 32% cases as seropositive respectively, IFAT being most specific (100%) and ELISA most sensitive (41.37%). Insignificant change in Ab titre was observed in sequential samples of seropositive cases. Posterior Uveitis cases had the maximum seropositivity (41.7%). Highest seropositivity was in 16-25 years age group with no sex preponderance. Dietary habits and occupational history had no bearing on Toxoplasma infection. Results indicate that serology in mandatory for diagnosing Toxoplasma as a cause of uveitis, 2 or more tests on a single serum sample detecting IgG and Igm Ab are the best indicators of infection.

Animals↗